Ann Dermatol.  2013 Nov;25(4):428-433. 10.5021/ad.2013.25.4.428.

Clinical and Histological Correlation in Post-Burn Hypertrophic Scar for Pain and Itching Sensation

• Choi YH
• Kim KM
• Kim HO
• Jang YC
• Kwak IS

• KMID: 2265050
• DOI: http://doi.org/10.5021/ad.2013.25.4.428

Abstract

BACKGROUND
Hypertrophic scar following a burn is caused by the excessive deposit of collagen resulting in an exaggerated wound healing response. The burn patient complains of pain and itching over the scar, which can give rise to cosmetic and functional problems.
OBJECTIVE
The aim of this study was to investigate the clinical and histological correlation of a hypertrophic burn scar for itching and pain sensations.
METHODS
Thirty-eight patients underwent a scar release and skin graft. the modified Vancouver scar scale and the verbal numerical rating scale were recorded. All biopsies were taken from scar tissue (scar) and normal tissue (normal). Histologically, tissues were observed in the epidermis, the monocytes around the vessels, the collagen fiber, elastic fiber, and the mast cells.
RESULTS
The mean total score of MVSS was 8.4+/-2.7 (pliability 2.0+/-0.9; thickness 1.8+/-0.9; vascularity 2.0+/- 0.9; and pigmentation 2.1+/-0.9). Pain and itching were 2.4+/-2.0 and 2.9+/-3.0. Epidermis were 7.9+/-2.8 layers (scar) and 4.0+/-0.8 layers (normal). The collagen fibers were thin and dense (scar) and thicker and loose (normal). The elastic fibers were thin and nonexistent (scar) and thin and loose (normal). Mast cells were 11.2+/-5.8/high power field (scar) and 7.4+/-4.1 (normal).
CONCLUSION
As the scar tissue thickens, the itching becomes more severe. The stiffness of the scar with the pain appeared to be associated with the condition of the tissue. The correlation between clinical and histological post-burn hypertrophic scars will help further studies on the scar. This helped with the development of the base material for therapeutic strategies.

Keyword

Hypertrophic scar; Itching; Pain

MeSH Terms

Biopsy
Burns
Cicatrix
Cicatrix, Hypertrophic*
Collagen
Elastic Tissue
Epidermis
Humans
Mast Cells
Monocytes
Pigmentation
Pruritus*
Sensation*
Skin
Transplants
Wound Healing
Collagen

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